Autism and chronic ill health: an observational study of symptoms and diagnoses of central sensitivity syndromes in autistic adults

[Hoopoe]

https://molecularautism.biomedcentral.com/articles/10.1186/s13229-022-00486-6

Background
Autistic adults, particularly women, are more likely to experience chronic ill health than the general population. Central sensitivity syndromes (CSS) are a group of related conditions that are thought to include an underlying sensitisation of the central nervous system; heightened sensory sensitivity is a common feature. Anecdotal evidence suggests autistic adults may be more prone to developing a CSS. This study aimed to investigate the occurrence of CSS diagnoses and symptoms in autistic adults, and to explore whether CSS symptoms were related to autistic traits, mental health, sensory sensitivity, or gender.

Methods
The full sample of participants included 973 autistic adults (410 men, 563 women, mean age = 44.6) registered at the Netherlands Autism Register, who completed questionnaires assessing autistic traits, sensory sensitivity, CSS, physical and mental health symptoms. The reliability and validity of the Central Sensitization Inventory (CSI) in an autistic sample was established using exploratory and confirmatory factor analyses. Chi2 analyses, independent t-tests, hierarchical regression and path analysis were used to analyse relationships between CSS symptoms, autistic traits, measures of mental health and wellbeing, sensory sensitivity, age and gender.

Results
21% of participants reported one or more CSS diagnosis, and 60% scored at or above the clinical cut-off for a CSS. Autistic women were more likely to report a CSS diagnosis and experienced more CSS symptoms than men. Sensory sensitivity, anxiety, age and gender were significant predictors of CSS symptoms, with sensory sensitivity and anxiety fully mediating the relationship between autistic traits and CSS symptoms.

Limitations
Although this study included a large sample of autistic adults, we did not have a control group or a CSS only group. We also could not include a non-binary group due to lack of statistical power.

Conclusions
CSS diagnoses and symptoms appear to be very common in the autistic population. Increased awareness of an association between autism and central sensitisation should inform clinicians and guide diagnostic practice, particularly for women where CSS are common and autism under recognised.

In our large sample of autistic adults, 21% reported a CSS diagnosis of FMS, ME/CFS, IBS, RLS or TMJD and 60% scored at or above the clinical cut-off for a CSS on the CSI, suggesting that CSS symptoms are very common in autistic people.

 

[rvallee]

For sure, if you compare a bunch of rocks with a bunch of fossils that look like rocks in a time when you don't have the technology to tell them apart, you can conclude anything you want! Are they all rocks? If you want! Are none of them rocks? Sure, whatever! Maybe they're related to rainbows, too. If you want!

But the idea that the stuff that's put in that kitchen drawer that is filled with all the stuff that doesn't belong in other drawers is 'related' in any other way than they don't belong in other drawers is just silly. Quite being silly and let adults handle this, damnit.

 

[Snow Leopard]

I'm usually suspicious of studies that don't quantify the rate of people who returned questionnaires versus the number contacted.

The choice to return the questionnaire is a major participation bias despite the researchers claim that their cohort is hardly biased.